Individual provider Active NPI

Ada Chaeli Van Der Zijp-Tan

  • Family Medicine Physician
  • Mobile, AL
National Provider Identifier
1972398352
Registry record updated Nov 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
L6613 Issued in AL
Practice address
2451 University Hospital Dr # 212
Mobile, AL 36617-2300
Phone
(251) 434-3475
NPI assigned
Apr 14, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X L6613 AL Primary

Addresses

Primary practice location

2451 University Hospital Dr # 212
Mobile, AL 36617-2300

Mailing address

2451 University Hospital Dr # 212
Mobile, AL 36617-2300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250909003218 AL Order and Referring Only - Family PracticePractitioner - Family Practice 2264934058

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L6613ALMDFamily Medicine Physician

Interoperability endpoints

  • Direct secure messaging: ada.van.der.zipj-tan.1@27270.direct.athenahealth.com

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1744588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762905600000",
    "number": "1972398352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2451 UNIVERSITY HOSPITAL DR # 212",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366172300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2451 UNIVERSITY HOSPITAL DR # 212",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366172300",
            "telephone_number": "251-434-3475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DER ZIJP-TAN",
        "first_name": "ADA CHAELI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-14",
        "last_updated": "2025-11-12",
        "certification_date": "2025-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "L6613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.